This bill (PSA Screening for HIM Act) changes section 2713 of the Public Health Service Act. It requires group health plans and health insurance issuers offering group or individual coverage to cover, without cost-sharing, additional evidence-based preventive care and screenings for prostate cancer for men age 40 and over who are at high risk. The bill specifically names African-American men and men with a defined family history of prostate cancer as high-risk. The bill also adds a definition of "men with a family history of prostate cancer" to include certain first-degree relatives with a diagnosis, death, related cancers, or genetic alterations. The amendment takes effect for plan years beginning on or after January 1, 2026. The bill text also includes findings about prostate cancer rates, survival differences by stage, and disparities affecting African-American men, and it contains a clarification about which breast cancer screening recommendations are treated as current for purposes of the law.
If you are a man age 40 or older who is considered high risk (including African-American men or men who meet the bill's definition of a family history), your employer plan or individual market insurance must provide coverage for additional prostate cancer preventive services and screenings without requiring copayments, coinsurance, or other cost-sharing. The change applies to group health plans and health insurance issuers offering group or individual coverage. No publicly available information in the bill text explains how the change would apply to federal programs like Medicare or Medicaid.
No publicly available information on estimated federal or insurer costs is included in the bill text. The bill does state in its findings that treating metastatic prostate cancer costs "hundreds of millions of dollars more annually" than treating localized, early-stage cancer, but it does not provide budget estimates or analyses.
The bill text states that sponsors and supporters view prostate cancer screening for high-risk men as important because early-stage prostate cancer has a near 100 percent survival rate while late-stage disease has much lower survival. The findings in the bill note higher diagnosis and death rates among African-American men and increased risk for men with a family history. The text says many major cancer and urological societies recommend earlier screening discussions for these groups and that lowering barriers to screening could help detect cancers before they spread.
No publicly available information in the bill text describes opponents' views, formal objections, or arguments against the bill.